Provider Demographics
NPI:1972896587
Name:COMPASS POINT ADOLESCENT SERVICES
Entity Type:Organization
Organization Name:COMPASS POINT ADOLESCENT SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:DOYLE
Authorized Official - Middle Name:DEWAYNE
Authorized Official - Last Name:DAISS
Authorized Official - Suffix:
Authorized Official - Credentials:MS ED
Authorized Official - Phone:402-463-5075
Mailing Address - Street 1:225 N SAINT JOSEPH AVE
Mailing Address - Street 2:
Mailing Address - City:HASTINGS
Mailing Address - State:NE
Mailing Address - Zip Code:68901-7555
Mailing Address - Country:US
Mailing Address - Phone:402-463-5075
Mailing Address - Fax:402-463-5073
Practice Address - Street 1:225 N SAINT JOSEPH AVE
Practice Address - Street 2:
Practice Address - City:HASTINGS
Practice Address - State:NE
Practice Address - Zip Code:68901-7555
Practice Address - Country:US
Practice Address - Phone:402-463-5075
Practice Address - Fax:402-463-5073
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-16
Last Update Date:2011-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE77101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty